ER Physician Group at Jackson Hospital

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ER PHYSICIAN GROUP AT JACKSON HOSPITAL

Doing business as

Chipola Quick Care Alford & Primary Care

Practice address

1798 Georgia St
Alford, FL 32420-6800

Phone

(850) 526-6727

Fax

(850) 526-1027

NPI assigned

Jun 3, 2021

Last updated

Jan 16, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

ER PHYSICIAN GROUP AT JACKSON HOSPITALAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Margaret Carter

Title

Payer Credentialing Coordinator

Phone

(850) 718-2531

Specialties & licenses 2

Addresses

Other names 1

• Chipola Quick Care Alford & Primary Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

ER Phy GRP at Jackson H3 organizations share this tax ID, including this one

Part of

ER Phy GRP at Jackson H

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• ER Physician Group at Jackson Hospital

  dba Womens Healthcare of The Panhandle

  • Specialist
  • Marianna, FL
  • NPI 1407895584
  NPD tax ID
• ER Physician Group at Jackson Hospital

  dba Women's Healthcare of the Panhandle

  • Specialist
  • Marianna, FL
  • NPI 1790732881
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1356917892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 HOSPITAL DR",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461917",
            "telephone_number": "850-526-6727",
            "fax_number": "850-526-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1798 GEORGIA ST",
            "city": "ALFORD",
            "state": "FL",
            "postal_code": "324206800",
            "telephone_number": "850-526-6727",
            "fax_number": "850-526-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ER PHYSICIAN GROUP AT JACKSON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ER PHYSICIAN GROUP AT JACKSON HOSPITAL",
        "enumeration_date": "2021-06-03",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "PAYER CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "850-718-2531"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chipola Quick Care Alford & Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melody Lynn Duke, MSCCCSLP
• Kristin G Fenton, A.R.N.P.
• Trisha Leanna Jones, APRN

• Multi-Specialty Clinic/Center in Alford, FL
• Providers in Alford, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.